Alterations in circulating vasoactive substances in the critically ill: a comparison between survivors and non-survivors
Regulation of circulatory homeostasis is based on several factors including various circulating vasoactive substances. Whether these regulators differ between survivors and non-survivors was investigated in critically ill patients. Prospective study. Clinical investigation on a surgical intensive ca...
Gespeichert in:
| Veröffentlicht in: | Intensive care medicine 1995-03, Vol.21 (3), p.218-225 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 225 |
|---|---|
| container_issue | 3 |
| container_start_page | 218 |
| container_title | Intensive care medicine |
| container_volume | 21 |
| creator | BOLDT, J MENGES, T KUHN, D DIRIDIS, C HEMPELMANN, G |
| description | Regulation of circulatory homeostasis is based on several factors including various circulating vasoactive substances. Whether these regulators differ between survivors and non-survivors was investigated in critically ill patients.
Prospective study.
Clinical investigation on a surgical intensive care unit of an university hospital.
60 consecutive patients suffering from trauma (n = 21) or postoperative complications (n = 39) were studied prospectively. The patients were divided into survivors (n = 27) and non-survivors (n = 33). Therapy was adjusted to the standards of modern intensive care management by physicians who were not involved in the study.
Endothelin-1, atrial natriuretic peptide (ANP), vasopressin, renin, and catecholamine (epinephrine, norepinephrine) plasma levels were measured from arterial blood samples using radioimmunoassay (RIA) or high-pressure liquid chromatography (HPLC) technique on the day of admission to ICU and during the following 5 days. Various hemodynamic parameters were also monitored during that period. The non-survivors showed elevated pulmonary artery pressure (PAP: 34.1 +/- 5.4 mmHg) and pulmonary capillary wedge pressure (PCWP: 20.3 +/- 7.3 mmHg) already at the beginning of the study. Cardiac index (CI) did not differ among the groups, whereas right ventricular ejection fraction (RVEF) decreased in the non-survivors. PaO2/FIO2 decreased only in the non-survivors, whereas VO2 increased in the survivors (from 246 +/- 48 to 331 +/- 43 ml/min). Plasma levels of renin (from 206 +/- 40 to 595 +/- 81 pg/ml) and vasopressin (from 5.78 +/- 0.82 to 7.97 +/- 0.69 pg/ml) increased significantly in the non-survivors. Epinephrine and norepinephrine plasma concentrations were elevated in the non-survivors already at baseline and tremendously increased in these patients during the following days. ANP plasma levels significantly increased also only in the non-survivors (from 188 +/- 63 to 339 +/- 55 pg/ml) (p < 0.05). Endothelin-1 decreased in the survivors, whereas it significantly increased in the non-survivors (from 3.62 +/- 0.68 to 9.37 +/- 0.94 pg/ml) during the study period (p < 0.05). Analyses of co-variance revealed overall no significant correlation between circulating vasoactive substances and hemodynamics.
Systemic and regional regulators of the circulation were markedly changed by critical illness. In survivors, these regulators almost normalized within the study period of 5 days, whereas in non-survivors these alterations w |
| doi_str_mv | 10.1007/BF01701475 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_77343868</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>77343868</sourcerecordid><originalsourceid>FETCH-LOGICAL-p150t-41e2ca39776be79c57537fb88ef31142b59f65feba8b4c701c6ad63a861491ca3</originalsourceid><addsrcrecordid>eNo9kEFPxCAQhYnRrOvqxbsJB-OtCoUC9aYbV0028aLnhrJUMRRWoNX99xJt9jSZed-b5D0AzjG6xgjxm_sVwhxhyqsDMMeUlAUuiTgEc0RoWVBGy2NwEuMnyhir8AzMOK8RQ3wOfu5s0kEm412ExkFlghps3t07HGX0UiUzahiHNibplP6D0oeGKphklLR2B421t1BC5futDCZ6B1udvrV22RZGM_oQoXQb6Lwr9pdTcNRJG_XZNBfgbfXwunwq1i-Pz8u7dbHFFUoFxbpUktScs1bzWlW8IrxrhdAdwZiWbVV3rOp0K0VLVS5BMblhRAqGaY2zcwGu_v9ug_8adExNb6LS1kqn_RAbzgklgokMXkzg0PZ602yD6WXYNVNVWb-cdBlz7i7kOkzcY4RWROCa_ALsQXmR</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>77343868</pqid></control><display><type>article</type><title>Alterations in circulating vasoactive substances in the critically ill: a comparison between survivors and non-survivors</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>BOLDT, J ; MENGES, T ; KUHN, D ; DIRIDIS, C ; HEMPELMANN, G</creator><creatorcontrib>BOLDT, J ; MENGES, T ; KUHN, D ; DIRIDIS, C ; HEMPELMANN, G</creatorcontrib><description>Regulation of circulatory homeostasis is based on several factors including various circulating vasoactive substances. Whether these regulators differ between survivors and non-survivors was investigated in critically ill patients.
Prospective study.
Clinical investigation on a surgical intensive care unit of an university hospital.
60 consecutive patients suffering from trauma (n = 21) or postoperative complications (n = 39) were studied prospectively. The patients were divided into survivors (n = 27) and non-survivors (n = 33). Therapy was adjusted to the standards of modern intensive care management by physicians who were not involved in the study.
Endothelin-1, atrial natriuretic peptide (ANP), vasopressin, renin, and catecholamine (epinephrine, norepinephrine) plasma levels were measured from arterial blood samples using radioimmunoassay (RIA) or high-pressure liquid chromatography (HPLC) technique on the day of admission to ICU and during the following 5 days. Various hemodynamic parameters were also monitored during that period. The non-survivors showed elevated pulmonary artery pressure (PAP: 34.1 +/- 5.4 mmHg) and pulmonary capillary wedge pressure (PCWP: 20.3 +/- 7.3 mmHg) already at the beginning of the study. Cardiac index (CI) did not differ among the groups, whereas right ventricular ejection fraction (RVEF) decreased in the non-survivors. PaO2/FIO2 decreased only in the non-survivors, whereas VO2 increased in the survivors (from 246 +/- 48 to 331 +/- 43 ml/min). Plasma levels of renin (from 206 +/- 40 to 595 +/- 81 pg/ml) and vasopressin (from 5.78 +/- 0.82 to 7.97 +/- 0.69 pg/ml) increased significantly in the non-survivors. Epinephrine and norepinephrine plasma concentrations were elevated in the non-survivors already at baseline and tremendously increased in these patients during the following days. ANP plasma levels significantly increased also only in the non-survivors (from 188 +/- 63 to 339 +/- 55 pg/ml) (p < 0.05). Endothelin-1 decreased in the survivors, whereas it significantly increased in the non-survivors (from 3.62 +/- 0.68 to 9.37 +/- 0.94 pg/ml) during the study period (p < 0.05). Analyses of co-variance revealed overall no significant correlation between circulating vasoactive substances and hemodynamics.
Systemic and regional regulators of the circulation were markedly changed by critical illness. In survivors, these regulators almost normalized within the study period of 5 days, whereas in non-survivors these alterations were even aggravated. It can only be speculated whether these regulator systems were influenced by activation of various mediator systems or whether they themselves influenced the negative outcome in the non-survivors.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/BF01701475</identifier><identifier>PMID: 7790607</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; APACHE ; Atrial Natriuretic Factor - blood ; Biological and medical sciences ; Chromatography, High Pressure Liquid ; Critical Illness - mortality ; Female ; Hemodynamics ; Humans ; Intensive care medicine ; Intensive Care Units ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Oxygen Consumption ; Postoperative Complications - blood ; Postoperative Complications - mortality ; Prospective Studies ; Radioimmunoassay ; Survivors ; Vasoconstrictor Agents - blood ; Wounds and Injuries - blood ; Wounds and Injuries - mortality</subject><ispartof>Intensive care medicine, 1995-03, Vol.21 (3), p.218-225</ispartof><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3453819$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7790607$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BOLDT, J</creatorcontrib><creatorcontrib>MENGES, T</creatorcontrib><creatorcontrib>KUHN, D</creatorcontrib><creatorcontrib>DIRIDIS, C</creatorcontrib><creatorcontrib>HEMPELMANN, G</creatorcontrib><title>Alterations in circulating vasoactive substances in the critically ill: a comparison between survivors and non-survivors</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><description>Regulation of circulatory homeostasis is based on several factors including various circulating vasoactive substances. Whether these regulators differ between survivors and non-survivors was investigated in critically ill patients.
Prospective study.
Clinical investigation on a surgical intensive care unit of an university hospital.
60 consecutive patients suffering from trauma (n = 21) or postoperative complications (n = 39) were studied prospectively. The patients were divided into survivors (n = 27) and non-survivors (n = 33). Therapy was adjusted to the standards of modern intensive care management by physicians who were not involved in the study.
Endothelin-1, atrial natriuretic peptide (ANP), vasopressin, renin, and catecholamine (epinephrine, norepinephrine) plasma levels were measured from arterial blood samples using radioimmunoassay (RIA) or high-pressure liquid chromatography (HPLC) technique on the day of admission to ICU and during the following 5 days. Various hemodynamic parameters were also monitored during that period. The non-survivors showed elevated pulmonary artery pressure (PAP: 34.1 +/- 5.4 mmHg) and pulmonary capillary wedge pressure (PCWP: 20.3 +/- 7.3 mmHg) already at the beginning of the study. Cardiac index (CI) did not differ among the groups, whereas right ventricular ejection fraction (RVEF) decreased in the non-survivors. PaO2/FIO2 decreased only in the non-survivors, whereas VO2 increased in the survivors (from 246 +/- 48 to 331 +/- 43 ml/min). Plasma levels of renin (from 206 +/- 40 to 595 +/- 81 pg/ml) and vasopressin (from 5.78 +/- 0.82 to 7.97 +/- 0.69 pg/ml) increased significantly in the non-survivors. Epinephrine and norepinephrine plasma concentrations were elevated in the non-survivors already at baseline and tremendously increased in these patients during the following days. ANP plasma levels significantly increased also only in the non-survivors (from 188 +/- 63 to 339 +/- 55 pg/ml) (p < 0.05). Endothelin-1 decreased in the survivors, whereas it significantly increased in the non-survivors (from 3.62 +/- 0.68 to 9.37 +/- 0.94 pg/ml) during the study period (p < 0.05). Analyses of co-variance revealed overall no significant correlation between circulating vasoactive substances and hemodynamics.
Systemic and regional regulators of the circulation were markedly changed by critical illness. In survivors, these regulators almost normalized within the study period of 5 days, whereas in non-survivors these alterations were even aggravated. It can only be speculated whether these regulator systems were influenced by activation of various mediator systems or whether they themselves influenced the negative outcome in the non-survivors.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>APACHE</subject><subject>Atrial Natriuretic Factor - blood</subject><subject>Biological and medical sciences</subject><subject>Chromatography, High Pressure Liquid</subject><subject>Critical Illness - mortality</subject><subject>Female</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Oxygen Consumption</subject><subject>Postoperative Complications - blood</subject><subject>Postoperative Complications - mortality</subject><subject>Prospective Studies</subject><subject>Radioimmunoassay</subject><subject>Survivors</subject><subject>Vasoconstrictor Agents - blood</subject><subject>Wounds and Injuries - blood</subject><subject>Wounds and Injuries - mortality</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kEFPxCAQhYnRrOvqxbsJB-OtCoUC9aYbV0028aLnhrJUMRRWoNX99xJt9jSZed-b5D0AzjG6xgjxm_sVwhxhyqsDMMeUlAUuiTgEc0RoWVBGy2NwEuMnyhir8AzMOK8RQ3wOfu5s0kEm412ExkFlghps3t07HGX0UiUzahiHNibplP6D0oeGKphklLR2B421t1BC5futDCZ6B1udvrV22RZGM_oQoXQb6Lwr9pdTcNRJG_XZNBfgbfXwunwq1i-Pz8u7dbHFFUoFxbpUktScs1bzWlW8IrxrhdAdwZiWbVV3rOp0K0VLVS5BMblhRAqGaY2zcwGu_v9ug_8adExNb6LS1kqn_RAbzgklgokMXkzg0PZ602yD6WXYNVNVWb-cdBlz7i7kOkzcY4RWROCa_ALsQXmR</recordid><startdate>199503</startdate><enddate>199503</enddate><creator>BOLDT, J</creator><creator>MENGES, T</creator><creator>KUHN, D</creator><creator>DIRIDIS, C</creator><creator>HEMPELMANN, G</creator><general>Springer</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>199503</creationdate><title>Alterations in circulating vasoactive substances in the critically ill: a comparison between survivors and non-survivors</title><author>BOLDT, J ; MENGES, T ; KUHN, D ; DIRIDIS, C ; HEMPELMANN, G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p150t-41e2ca39776be79c57537fb88ef31142b59f65feba8b4c701c6ad63a861491ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>APACHE</topic><topic>Atrial Natriuretic Factor - blood</topic><topic>Biological and medical sciences</topic><topic>Chromatography, High Pressure Liquid</topic><topic>Critical Illness - mortality</topic><topic>Female</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Oxygen Consumption</topic><topic>Postoperative Complications - blood</topic><topic>Postoperative Complications - mortality</topic><topic>Prospective Studies</topic><topic>Radioimmunoassay</topic><topic>Survivors</topic><topic>Vasoconstrictor Agents - blood</topic><topic>Wounds and Injuries - blood</topic><topic>Wounds and Injuries - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BOLDT, J</creatorcontrib><creatorcontrib>MENGES, T</creatorcontrib><creatorcontrib>KUHN, D</creatorcontrib><creatorcontrib>DIRIDIS, C</creatorcontrib><creatorcontrib>HEMPELMANN, G</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BOLDT, J</au><au>MENGES, T</au><au>KUHN, D</au><au>DIRIDIS, C</au><au>HEMPELMANN, G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alterations in circulating vasoactive substances in the critically ill: a comparison between survivors and non-survivors</atitle><jtitle>Intensive care medicine</jtitle><addtitle>Intensive Care Med</addtitle><date>1995-03</date><risdate>1995</risdate><volume>21</volume><issue>3</issue><spage>218</spage><epage>225</epage><pages>218-225</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>Regulation of circulatory homeostasis is based on several factors including various circulating vasoactive substances. Whether these regulators differ between survivors and non-survivors was investigated in critically ill patients.
Prospective study.
Clinical investigation on a surgical intensive care unit of an university hospital.
60 consecutive patients suffering from trauma (n = 21) or postoperative complications (n = 39) were studied prospectively. The patients were divided into survivors (n = 27) and non-survivors (n = 33). Therapy was adjusted to the standards of modern intensive care management by physicians who were not involved in the study.
Endothelin-1, atrial natriuretic peptide (ANP), vasopressin, renin, and catecholamine (epinephrine, norepinephrine) plasma levels were measured from arterial blood samples using radioimmunoassay (RIA) or high-pressure liquid chromatography (HPLC) technique on the day of admission to ICU and during the following 5 days. Various hemodynamic parameters were also monitored during that period. The non-survivors showed elevated pulmonary artery pressure (PAP: 34.1 +/- 5.4 mmHg) and pulmonary capillary wedge pressure (PCWP: 20.3 +/- 7.3 mmHg) already at the beginning of the study. Cardiac index (CI) did not differ among the groups, whereas right ventricular ejection fraction (RVEF) decreased in the non-survivors. PaO2/FIO2 decreased only in the non-survivors, whereas VO2 increased in the survivors (from 246 +/- 48 to 331 +/- 43 ml/min). Plasma levels of renin (from 206 +/- 40 to 595 +/- 81 pg/ml) and vasopressin (from 5.78 +/- 0.82 to 7.97 +/- 0.69 pg/ml) increased significantly in the non-survivors. Epinephrine and norepinephrine plasma concentrations were elevated in the non-survivors already at baseline and tremendously increased in these patients during the following days. ANP plasma levels significantly increased also only in the non-survivors (from 188 +/- 63 to 339 +/- 55 pg/ml) (p < 0.05). Endothelin-1 decreased in the survivors, whereas it significantly increased in the non-survivors (from 3.62 +/- 0.68 to 9.37 +/- 0.94 pg/ml) during the study period (p < 0.05). Analyses of co-variance revealed overall no significant correlation between circulating vasoactive substances and hemodynamics.
Systemic and regional regulators of the circulation were markedly changed by critical illness. In survivors, these regulators almost normalized within the study period of 5 days, whereas in non-survivors these alterations were even aggravated. It can only be speculated whether these regulator systems were influenced by activation of various mediator systems or whether they themselves influenced the negative outcome in the non-survivors.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>7790607</pmid><doi>10.1007/BF01701475</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0342-4642 |
| ispartof | Intensive care medicine, 1995-03, Vol.21 (3), p.218-225 |
| issn | 0342-4642 1432-1238 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_77343868 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy APACHE Atrial Natriuretic Factor - blood Biological and medical sciences Chromatography, High Pressure Liquid Critical Illness - mortality Female Hemodynamics Humans Intensive care medicine Intensive Care Units Male Medical sciences Middle Aged Miscellaneous Oxygen Consumption Postoperative Complications - blood Postoperative Complications - mortality Prospective Studies Radioimmunoassay Survivors Vasoconstrictor Agents - blood Wounds and Injuries - blood Wounds and Injuries - mortality |
| title | Alterations in circulating vasoactive substances in the critically ill: a comparison between survivors and non-survivors |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T02%3A48%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Alterations%20in%20circulating%20vasoactive%20substances%20in%20the%20critically%20ill:%20a%20comparison%20between%20survivors%20and%20non-survivors&rft.jtitle=Intensive%20care%20medicine&rft.au=BOLDT,%20J&rft.date=1995-03&rft.volume=21&rft.issue=3&rft.spage=218&rft.epage=225&rft.pages=218-225&rft.issn=0342-4642&rft.eissn=1432-1238&rft.coden=ICMED9&rft_id=info:doi/10.1007/BF01701475&rft_dat=%3Cproquest_pubme%3E77343868%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=77343868&rft_id=info:pmid/7790607&rfr_iscdi=true |